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Papers of the Week

Papers: 15 Jan 2022 - 21 Jan 2022

Pharmacology/Drug Development

2022 Jan

Pain Physician



Safety of Interlaminar Cervical Epidural Injections: Experience With 12,168 Procedures in a Single Pain Clinic.


Schultz DM, Hagedorn JM, Abd-Elsayed A, Stayner S
Pain Physician. 2022 Jan; 25(1):49-58.
PMID: 35051144.


Cervical epidural steroid injections have long been utilized to treat intraspinal inflammation causing cervicalgia and/or cervical radiculopathy, and much has been written about safety and efficacy. There are published opinions, without evidence basis, that these injections should not be performed above C7-T1 for fear of dural puncture, spinal cord injury, and other complications that might occur more frequently at higher spinal levels. However, many experienced interventional pain physicians believe that epidural injections targeted to the level of spinal inflammation may be more effective. Although medication injected at the lowest cervical level C7-T1 may ascend to higher spinal levels, it often does not since inflammation and swelling at the cervical level of pathology may increase epidural pressure causing the injectate to move caudally down the path of least resistance.